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PERMIT EXPIRES
CITY OF EDMONDS
ILEF PERMIT
ZG,, NUMBER Z006,36
CONSTRUCTION PERMIT APPLICATION
OWNER NAMEINAME OF BUSINESS
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PROGRESS INSPECTIONS PER UBC 108
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THIS PERMIT AUTHO RES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
BE ONE ON PRIVATE PROPERTY ONLY ANY CONSTRUCTION ON THE PUB LIS
GRADINGIFILL 2-4)
:i DOMAIN (CURSS,SIDEWALKS, DRIVEWAYS' MARQUEE%ETC.) WILL REOUIR E
t: SEPARATE PERMISSION.
T PERMIT APPLICATI.W 180 DAYS
PERMIT LIMIT. 1 YEAR - PROVIDED WORK IS STARTED WITHIN 180 BAYS
STATE SURlHlFGl
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'APPLICANT. ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCEEDING
IN INTEREST. AGREES TO INDEMNIFY, DEFEND AND HOLD HARML SS THE CITY 01
ENG, INSPECTION FEE
EDMONDS, ASHINGTON. ITS OFFICIALS, EMPLOYEES. AND AGENT S 'ROM ANYAND
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ALLCL IMS FOR DAMAGES OF WHATEVER NATURE,AqISIN ORECTLYORINDIRECTLY
o F ON THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THI S PERM T SHALL NOT BE
0 DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
NOR LIMIT IN ANYWAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION'
PLAN CHECK DEPOSIT
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TOTAL AMOUN r DUE
I HERE Y ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION, THAT THE INFOEIMATION
GIVEN IS CORRECT. AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
APPLICATION APPROVAL
THEOWNER, JAGSEETOCOMP WITH CITY AND STATE LAWS REGULATING CONSTRUC
TION, AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL OF, EMPLOYED
CALL
IN VIOLATION OF THE LABOR ODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION
WORKMEN S COMPENSATION INSURANCE AND RCW $8 27,
I'D TUR��F�R T I RE7NED
EIGNAIURE Z,l JIAIE
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771-0220
ATTENTION
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TILL,_ BY
11 IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI,
C ATE OF OCCUPANCY HAS BEEN GRANTED, UBC SECTION 109
OFIGINAl 1�1 I - YII
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RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS
FOUNDATION:
Footing ......................
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Pier/Porch
Retaining Wall
Slab Insulation
PLUMBING:
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HEATING:
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EXTERIOR SHEATHING
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INSULATION
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Ceiling insulation
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SHEETROCK NAILING
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SPECIAL INSPECTION
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